Ibáñez-Martínez E, Ruiz-Gaitán A, Pemán-García J
Javier Pemán-García, Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
Rev Esp Quimioter. 2017 Sep;30 Suppl 1:16-21.
The number of patients at risk of suffering invasive fungal infection (IFI) is increasing. Because of its high mortality, new rapid and accurate diagnostic tools are needed. Last advances in invasive candidiasis diagnosis comprise Peptide Nucleic Acid Fluorescent In-Situ Hybridization (PNA-FISH), direct MALDI-TOF or multiplex acid nucleic testing. While all of them rely in positive blood cultures, T2Candida uses PCR coupled with T2Magnetic resonance detection directly in whole blood, allowing detection of 1-3 UFC/mL of Candida in about four hours. Beyond galactomannan (GM), novelties in IFI caused by molds include the international standardization of PCR techniques, with several commercial kits available. A combination of GM and PCR appears to be a good diagnostic strategy for invasive aspergillosis. PCR coupled to electrospray ionization/mass spectrometry and detection of volatile organic compounds in exhaled air by gas chromatography/mass spectrometry are other promising approaches to IFI diagnostic that still need to be validated.
有侵袭性真菌感染(IFI)风险的患者数量正在增加。由于其高死亡率,需要新的快速准确的诊断工具。侵袭性念珠菌病诊断的最新进展包括肽核酸荧光原位杂交(PNA-FISH)、直接基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)或多重核酸检测。虽然它们都依赖于血培养阳性,但T2念珠菌检测法直接在全血中使用聚合酶链反应(PCR)结合T2磁共振检测,大约四小时就能检测出每毫升1-3个念珠菌细胞单位(UFC/mL)。除了半乳甘露聚糖(GM),由霉菌引起的IFI的新进展包括PCR技术的国际标准化,有几种商业试剂盒可供使用。GM和PCR相结合似乎是侵袭性曲霉病的一种良好诊断策略。PCR与电喷雾电离/质谱联用以及通过气相色谱/质谱检测呼出空气中的挥发性有机化合物是IFI诊断的其他有前景的方法,但仍需验证。